{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:50:20Z","timestamp":1782190220491,"version":"3.54.5"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003819","name":"Natural Science Foundation of Hubei Province","doi-asserted-by":"publisher","award":["2023AFD031"],"award-info":[{"award-number":["2023AFD031"]}],"id":[{"id":"10.13039\/501100003819","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psychological distress increases cancer risk, but its relationship to thyroid cancer risk remains unclear. The aims of our study were to assess whether psychological distress increases the risk of thyroid cancer, and to further explore the mediating factors between psychological distress and thyroid cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 420,187 participants aged 39\u201373 years between 2006 and 2010 in the UK biobank were included in the cohort study. Psychological distress was assessed using relevant hospitalization records, the four-item Patient Health Questionnaire and self-reported psychiatric symptoms. Thyroid cancer diagnosed date was from national cancer registries and hospital inpatient records in England, Wales, and Scotland. We used Cox proportional hazard models to calculate hazard ratios and the mediation R package to assess the mediating factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>With a median follow-up of 12.59 years, the incidence of thyroid cancer in the participants with psychological distress was 137.16 per 100,000, compared with 94.31 per 100,000 in the participants with non-psychological distress. Psychological distress significantly increased the risk of thyroid cancer (HR, 1.33; 95% CI, 1.09\u20131.62; P\u00a0=\u00a00.005). Mediation analysis indicated that BMI, waist circumference, high-density lipoprotein, triglycerides, alcohol consumption partially mediated between psychological distress and thyroid cancer, in which waist circumference had the strongest mediating effect by a proportion of 11.80% (95% CI, 4.41\u201336.00%; P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Psychological distress is associated with an increased risk of developing thyroid cancer, which is modestly mediated by obesity, dyslipidemia, and alcohol consumption. The hypothesis that managing weight, lipids, and alcohol intake might mitigate cancer risk in individuals with psychological distress requires direct testing in future intervention trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1822262","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:33:53Z","timestamp":1782189233000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between psychological distress and thyroid cancer, and the mediating role of lifestyle and metabolism: a cohort study from the UK Biobank"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-lin","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]},{"name":"Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-qi","family":"You","sequence":"additional","affiliation":[{"name":"Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-jing","family":"Zeng","sequence":"additional","affiliation":[{"name":"Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-xiang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-yong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]},{"name":"Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1186\/s13045-021-01213-z","article-title":"Global, regional, and national cancer incidence and death for 29 cancer groups in 2019 and trends analysis of the global cancer burden, 1990-2019","volume":"14","author":"Lin","year":"2021","journal-title":"J Hematol Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4706","article-title":"Thyroid cancer: zealous imaging has increased detection and treatment of low risk tumours","volume":"347","author":"Brito","year":"2013","journal-title":"Bmj"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1604412","article-title":"Worldwide thyroid-cancer epidemic? 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